Giant Hydronephrosis and pelvi ureteric junction obstroction

Clinical case presentation of giant hydronephrosis

1. Clinical history 9 year male child Full term normal vaginal delivery Milestones normal, vaccination complete Chief complaint : Right flank pain for 1-2 month Vague, no vomiting, No urinary complaint, No dyuria , No fever, No bowel problem.

2. General Examination GC – conscious, well oriented & cooperative Pulse : 112/min B.P. = 110/70 mmHg Performance status : ECOG 0 No pallor/ icterus / lymphadenopathy , no pedal oedema

3. Abd examination Rt kidney – Palpable – 3-4 cm below costal margin, Non tender, Reaching upto RIF, Moving with respiration, Left kidney – not palpable Bladder 0 not palpable Both testis cord – normal, No phimosis – good hygine

4. Investigations Haemoglobin - 12.7gm% WBC- 5860/ uL Platelets 185000lakhs/ uL Serum Creatinine- 0.62mg/dl Urine – R/M – No protein, No sugar, Occ pus cells, No RBC

5. USG KUB

6. CT IVP

7. DTPA Functional scan : LK : 63% SF, 32 GFR RK : 37% SF, 18 GFR